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**Carboplatin + ifosfamide + topotecan (TIC)** is a combination chemotherapy regimen investigated for relapsed/refractory solid tumors, lymphomas, and Wilms tumors in pediatric patients. **Carboplatin** is a platinum-based alkylating agent that crosslinks DNA, inducing cell death; **ifosfamide** is an oxazaphosphorine alkylating agent that forms DNA adducts after metabolic activation; **topotecan** is a camptothecin analog that inhibits topoisomerase I, stabilizing the enzyme-DNA cleavage complex to prevent DNA religation. The regimen substitutes topotecan for etoposide in the established ICE regimen to reduce leukemogenicity while maintaining efficacy through additive/synergistic antitumor effects. Clinical trials have demonstrated feasibility, tolerability, and an overall response rate of 43% in poor-risk pediatric patients with recurrent solid tumors.[1][5][6]
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